Crohn's disease in children is generally diagnosed and monitored using CT and MRI scans, but researchers have just won a grant to find out whether new ultrasound techniques can better predict outcomes while costing less and allowing patients to avoid sedation or radiation exposure.

"It's cheap, it's real-time, the child can sit next to the parent and hold (their) hand," Dr. Jonathan Dillman, lead researcher and a pediatric radiologist at University of Michigan in Ann Arbor, told DOTmed News about ultrasound.

The grant, from Agfa Healthcare and the Radiological Society of North America, will provide $75,000 a year for the two-year study, mostly to cover Dillman's salary for his time spent on the research, he said.

The grant is part of a $500,000 package given by Agfa to support radiology research over the next half decade. It was announced Wednesday.

Crohn's disease causes chronic inflammation of the small bowel and the colon, often triggering episodes of diarrhea, abdominal pain and gastrointestinal bleeding. The disease, which in children can lead to malnutrition, failure to thrive and surgical removal of sections of the intestine, possibly affects some 700,000 Americans, according to the Crohn's & Colitis Foundation of America.

For the past decade, CT and more recently MRI have been the main tools for imaging Crohn's patients, Dillman said. At his hospital, Dillman said about half of adults with Crohn's get CT scans, and half MRIs. Children, however, because of radiation concerns, nearly always get MRIs. Each year, his institution performs about 200 MRIs of the bowel for children with known or suspected Crohn's disease, he said.

But children getting MRI often need to be sedated, which always carries a risk, and sedation is usually not required with ultrasound. Also, an ultrasound technology called shear wave elastrography might even provide information not gained by MRIs.

In elastography, ultrasound waves are used to map out tissue hardness. This could benefit Crohn's sufferers, Dillman said, as fibrosis, or the hardening of the bowel wall after long periods of inflammation, is a risk factor for two main complications of Crohn's: obstruction of the bowel, which often necessitates surgery, and fistulas, abnormal connections between segments of intestine or between the gut and other organs, such as the skin, vagina and bladder.

"Right now there's no non-invasive test to identify bowel-wall fibrosis," Dillman said. "MRI doesn't do it, CT doesn't do it, but we think ultrasound elastography could do it."

The study, which began last July, has so far recruited 15 patients. Dillman said they hope to enroll 30 by its end. "We're doing pretty good and are on target," he said about recruitment.

In the study, Dillman said they'll compare conventional gray-scale and Doppler ultrasound with MRI on patients with newly diagnosed small bowel Crohn's. The children will each receive five ultrasound scans from two different physicians over a six-month period. The researchers will compare the two physicians' scans with each other, to see if they agree.

The physicians will also perform elastography scans using equipment made by Siemens Healthcare, to see if changes in bowel wall hardening help predict outcomes. All ultrasounds will be performed by physicians, not sonographers, Dillman said.

"If patients present with very hard bowel wall, perhaps our study will show they should go to surgery sooner rather than later as they are likely to fail medical management," Dillman said.

The study will also involve blood samples to look for elevated inflammatory markers, and surveys for patients and their parents to say what they feel about each procedure and which imaging test they like best.